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      <h4 class="scenarios"><a href="implementation.html" class="blue">NwHIN 1.0 Portfolio</a> > <a href="scenarios.html" class="blue">Scenarios</a> > <a href="scenario_lri.html" class="blue">Delivering Lab Results</a></h4>
      <h1 class="testimonials">Delivering Lab Results</h1>
<h6>A laboratory sends a patient&rsquo;s lab results to the ordering physician:</h6>
      <div class="scenario_center"><p><img src="images/scenario_LRI.png" alt="S&amp;I Scenarios" title="A flow diagram illustrating the transfer of a patient's lab results report from the laboratory to the ordering physician via Direct. The lab technician sends the properly formatted lab results report to the ordering physician's Direct address, which has been verified in the Provider Directory. The message passes through the lab's HISP, where it is encrypted and sent to the ordering physician's HISP. The ordering physician's HISP decrypts the message & routes it to the ordering physician." /></p></div>
      <p>A patient visits a reference lab for blood work prior to an annual health checkup with his primary care physician. Once the tests are complete, the lab technician compiles the results and enters them into the reference lab&rsquo;s EHR. The lab technician then electronically delivers the lab results report to the primary care physician.</p>
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         <td width="40" align="left" valign="top"> <img src="images/clipboard_check.png" alt="Meaningful Use Objectives" /> </td>
         <td width="15">&nbsp;</td>
         <td valign="middle"><p class="mu"><strong>Meaningful Use Stage 2 Objectives related to lab results: </strong>Incorporate clinical lab-test results into Certified EHR Technology as structured data. <em>(Meaningful Use Menu Set 10 for EPs, Meaningful Use Menu Set 8 for EH/CAHs)</em>
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     <h6>Common workflow steps for this scenario:</h6>
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         <td width="40" align="left" valign="top"> <img src="images/scenario_1.png" alt="1" /> </td>
         <td width="15">&nbsp;</td>
         <td width="891" valign="middle">A technician at the lab extracts the patient&rsquo;s lab results report, which has been properly formatted according to the HL7 v.2.5.1 Laboratory Results Interface Implementation Guide, including using the Logistical Observation Identifiers names and Codes (LOINC) 2.38 vocabulary. The technician then authors a Direct message and attaches the lab results report. In order to select the primary care physician as the recipient, the technician accesses a search dialogue in the HISP's user interface, which queries a Provider Directory (adhering to the Certificate Discovery for Direct specification) for the right Direct address.</td>
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         <td height="15" align="left" valign="top">&nbsp;</td>
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         <td width="40" align="left" valign="top"> <img src="images/scenario_2.png" alt="2" /> </td>
         <td width="15">&nbsp;</td>
         <td width="891" valign="middle">The laboratory&rsquo;s HISP, a contracted brokering agent responsible for the management of security and transport for directed exchange, retrieves the primary care physician&rsquo;s digital certificate from the Provider Directory. The laboratory&rsquo;s HISP uses this certificate to encrypt the message and sends it to the primary care physician&rsquo;s HISP in accordance with the Applicability Statement for Secure Health Transport, which uses x.509 for certificates.</td>
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         <td height="15" align="left" valign="top">&nbsp;</td>
         <td height="15">&nbsp;</td>
         <td height="15" valign="middle">&nbsp;</td>
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         <td width="40" align="left" valign="top"><img src="images/scenario_3.png" alt="3" /> </td>
         <td width="15">&nbsp;</td>
         <td width="891" valign="middle">The primary care physician&rsquo;s HISP decrypts the message and routes it to the primary care physician.</td>
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         <td height="15" align="left" valign="top">&nbsp;</td>
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         <td width="40" align="left" valign="top"><img src="images/scenario_4.png" alt="4" /></td>
         <td width="15">&nbsp;</td>
         <td width="891" valign="middle">The primary care physician uses the HISP&rsquo;s user interface to access the lab report in his Direct inbox.</td>
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      <br />
      <h6>NwHIN 1.0 specifications and resources recommended for scenario:</h6>
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    <td width="300" align="left" valign="top" bgcolor="#0194D3"><h4 class="scenario2">Content Structure</h4>
      Guidance that specifies how to structure health information to ensure proper exchange
</td>
    <td align="left" valign="middle" bgcolor="#E6E6E6"><ul>
      <li><a href="http://wiki.siframework.org/file/view/V251_IG_SIF_LABRESULTS_R1_N1_v15_Pilot_Use_Only.pdf" target="_new">HL7 v.2.5.1 Laboratory Results Interface Implementation Guide</a></li>
    </ul></td>
  </tr>
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    <td width="300" align="left" valign="top" bgcolor="#002B54">
      <h4 class="scenario2">Vocabulary &amp; Code Sets</h4>
        Specifications that identify common naming convention necessary for proper health information exchange
    </td>
    <td align="left" valign="middle" bgcolor="#E6E6E6"><ul>
      <li><a href="http://loinc.org/" target="_new">Logistical Observation Identifiers names and Codes (LOINC) 2.38</a></li>
      </ul></td>
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    <td width="300" align="left" valign="top" bgcolor="#BF311A">
     <h4 class="scenario2">Transport and Security</h4>
       Mechanisms and processes that safely exchange health information over the Internet
</td>
    <td align="left" valign="middle" bgcolor="#E6E6E6"><ul>
      <li><a href="http://wiki.siframework.org/file/view/Certificate Discover for Direct Project Implementation Guide.pdf" target="_new">Certificate Discovery for Direct</a></li>
      <li><a href="http://wiki.directproject.org/Applicability+Statement+for+Secure+Health+Transport" target="_new">Applicability Statement for Secure Health Transport</a></li>
      <li><a href="http://tools.ietf.org/html/rfc5280" target="_new">x.509 for Certificates</a></li></ul></td>
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